Human Resources News & Insights

New psychiatric manual could drive HR managers crazy

A psychiatric reference book you may have never heard of could bring on severe anxiety symptoms for HR pros.  

The volume in question is called the Diagnostic and Statistical Manual of Mental Disorders — DSM-5, to insiders — and it’s been used as a diagnostic “bible” for mental illness for six decades. But the latest edition, released just days ago, has drawn a lot of criticism for broadening the definitions of certain disorders — and adding new ones.

The message to HR: You could be facing a lot more ADA and FMLA requests — and there’s no telling what effect there might be on your health plan costs.

A sign of just how controversial the new edition has become: The National Institute of Mental Health recently withdrew its support for the manual. The DSM is published by the American Psychiatric Association.

When normal becomes … a disorder?

What’s wrong with the DSM-5? “It offers a reckless hodgepodge of new diagnoses that will misidentify normals and subject them to unnecessary treatment and stigma,” Dr. Allen Frances recently wrote on psychologytoday.com.

The kinds of things Dr. Frances fears will change under the new DSM:

  • a drastic increase in people claiming to suffer from ADD
  • normal grief over a loved one’s death will automatically be classified as a “major depressive disorder”
  • older workers suffering from normal forgetfulness will be identified as suffering from “minor neurocognitive disorder,” and
  • other day-to-day behaviors that will suddenly fall into some psychiatric problem category.

Attorneys from the law firm of Hunton & Williams offered predictions of the DSM-5’s implications for employers. Here’s a look:

  • The EEOC will embrace the DSM-5’s expansive view of mental disorders and treat most of its newly-established conditions as disabilities for purposes of the Americans with Disabilities Act.
  •  EEOC will re-evaluate its longstanding ADA interpretive guidance on the definition of “physical or mental impairment” which states that an “impairment” does not include “common personality traits such as poor judgment or a quick temper where these are not symptoms of a mental or psychological disorder.”
  • The agency will more closely scrutinize disciplinary decisions and seek to force employers to reasonably accommodate allegedly disabled employees whose poor performance and conduct are more likely attributable to ordinary characteristics such as lack of motivation, incompetence, unwillingness to follow company rules, and inability to get along with supervisors and coworkers.
  •  Requests for time off that employers now routinely deny will require more scrutiny to determine if there is ADA or FMLA protection, as primary care physicians (who already prescribe most psychiatric medications) fall in line with DSM-5’s expansive diagnostic criteria.
  • Employer costs for benefits such as short-term disability will continue to increase, as will workers’ compensation costs in states with expansive definitions of what constitutes an occupational injury or disease.
  • Employees suing their former employer for infliction of emotional distress will find it easier to obtain a medical diagnosis to support their claim.

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